比较综合护理与传统护理对先天性心脏病患儿的影响：一项系统评价和荟萃分析。
Comparing the impact of comprehensive care with conventional care in children with congenital heart disease: a systematic review and meta-analysis.
作者信息
Wang Shijian, He Limei, Liu Shengnan, Zhang Xiangyun
机构信息
Department of Cardiovascular Surgery, The Second Affiliated Hospital of Hainan Medical University, Haikou, China.
Department of Pediatrics, Hainan Western Central Hospital, Danzhou, China.
出版信息
Transl Pediatr. 2023 Mar 31;12(3):417-428. doi: 10.21037/tp-23-96. Epub 2023 Mar 24.
BACKGROUND
This study compares the impact of comprehensive care and conventional care on interventional therapy in children with congenital heart disease and to provide a reference basis for clinical care.
METHODS
Clinical randomized controlled trials (RCTs) examining care during interventional therapy in children with congenital heart disease were identified in the PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang databases using a combination of subject terms and free terms. The retrieval time was from the establishment of the database to November 27th, 2022. The control group was given conventional care and the experimental group was given comprehensive care on the basis of conventional care. The outcome indicators included one or more of postoperative complications (number of cases), puncture time (minutes), pain score (points), surgical operation time (minutes), X-ray exposure time (minutes) and length of hospital stay (days). Meta-analysis was performed using Stata 14.0 software. The publication bias test was conducted using Harbor's test.
RESULTS
A total of 24 RCTs were eventually included, and a total of 2,028 study subjects were enrolled, including 1,025 in the test group and 1,003 in the control group. Meta-analysis showed that comprehensive care resulted in a lower risk of complications [risk ratio (RR) =0.27; 95% confidence interval (CI): 0.21 to 0.34]. Furthermore, subjects who received comprehensive care had lower puncture time [standardized mean difference (SMD) =-2.50; 95% CI: -3.23 to -1.77], lower operating time [SMD (95% CI): -2.50 (-3.31, -1.68)], lower X-ray exposition time [SMD (95% CI): -1.29 (-2.51, -0.07)], shorter length of hospital stay [SMD (95% CI): -1.57 (-2.04, -1.09)], and lower pain scores [SMD (95% CI): -2.43 (-3.20, -1.65)].
CONCLUSIONS
Comprehensive care has higher clinical utility, which is worthy of clinical application and popularization.
背景
本研究比较综合护理与传统护理对先天性心脏病患儿介入治疗的影响，为临床护理提供参考依据。
方法
通过主题词和自由词相结合的方式，在PubMed、Web of Science、Embase、中国知网（CNKI）和万方数据库中检索关于先天性心脏病患儿介入治疗期间护理的临床随机对照试验（RCT）。检索时间为各数据库建库至2022年11月27日。对照组给予传统护理，试验组在传统护理基础上给予综合护理。结局指标包括术后并发症（例数）、穿刺时间（分钟）、疼痛评分（分）、手术操作时间（分钟）、X线暴露时间（分钟）和住院时间（天）中的一项或多项。使用Stata 14.0软件进行Meta分析。采用Harbor检验进行发表偏倚检验。
结果
最终纳入24项RCT，共纳入2028例研究对象，其中试验组1025例，对照组1003例。Meta分析显示，综合护理可降低并发症风险[风险比（RR）=0.27；95%置信区间（CI）：0.21至0.34]。此外，接受综合护理的受试者穿刺时间更短[标准化均数差（SMD）=-2.50；95%CI：-3.23至-1.77]，手术操作时间更短[SMD（95%CI）：-2.50（-3.31，-1.68）]，X线暴露时间更短[SMD（95%CI）：-1.29（-2.51，-0.07）]，住院时间更短[SMD（95%CI）：-1.57（-2.04，-1.09）]，疼痛评分更低[SMD（95%CI）：-2.43（-3.20，-1.65）]。
结论
综合护理具有较高的临床应用价值，值得临床推广应用。
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